In the United States, youth sports dominate the lives of millions of young children and their families. With the pressure to start early, advance fast, train hard, and compete to win, sporting competition among our youth has been taken to a whole new level.
The U.S. Centers for Disease Control states that nearly 30 million children and adolescents participate in youth sports in the United States each year. According to the Sports Trauma Overuse and Prevention (STOP) campaign, sports injuries among our youth have reached epidemic heights and it is estimated that more than 3.5 million kids under the age of 14 receive medical treatment for sports injuries each year.
According to Dr. Peter Millett, an orthopedic surgeon specializing in shoulder and sports medicine in Vail, CO, “A vast majority of the youth sports injuries I treat each year are caused by overuse. Extensive training, beginning at very young ages, puts too much pressure on young joints that are still developing. This is why so many of our young athletes sustain injuries. It’s important to understand that while each child develops differently, most do not stop growing until after puberty. Until that time, the delicate tendons, ligaments, cartilage, muscles, and bones are vulnerable to injury.”
Once a child suffers an injury, particularly one that involves a joint, there is risk for future injury and the onset of premature degenerative changes.
Dr. Millett and the other orthopedic surgeons that make up the Steadman Clinic in Vail, are among an elite group of sports medicine specialists in the nation who are seeing an increase in the number of overuse injuries and acute injuries associated with sports trauma.
“Although I treat many traumatic injuries that are sustained in competition or recreational sports —for example fractured collarbones, dislocated shoulders, torn rotator cuffs that are caused from direct impact sports—more alarming, is the number of patients I am treating that have severe joint and cartilage damage from years of over-training and past injuries. I unfortunately have seen degenerative joint disease and the onset of arthritis as early as teenage years and now routinely perform surgery for osteoarthritis in young patients in their 30’s and 40’s,” said Dr. Millett.
Initial treatment for young patients who suffer damage to their joint will often be conservative with rest and rehabilitation. More advanced injuries may require arthroscopicsurgery to tighten shoulder ligaments or repair the labrum, which is a cartilage that can be torn from a traumatic injury or overuse. For young patients with significant cartilage damage, new joint preservation approaches are now available to help delay more radical techniques such as a full shoulder replacement.
“A particular interest of mine is shoulder arthritis in the active athlete,” states Dr. Millett. “Many times there are options other than joint replacement which preserve the shoulder and alleviate pain. Some of the newer techniques can delay the need for shoulder replacement surgery. Joint replacement surgery, although very effective, is best saved for older patients or when all other available treatments have been exhausted.”
The CAM procedure is one such technique that has been used successfully on young patients. CAM stands for Comprehensive Arthroscopic Management and it used for the treatment of advanced arthritis of the shoulder. Dr. Millett developed the CAM procedure as a treatment option for younger patients — predominantly athletes and active individuals — with advanced arthritis, as a means to delay full shoulder joint replacement surgery. Using a variety of minimally invasive arthroscopic surgery techniques and regenerative technologies, loose cartilage is removed from the shoulder joint and the bones are re-shaped to prevent compression on nerves, to alleviate pain, and to restore mobility. The CAM technique was designed in stages over the course of five years with a specific focus to alleviate pain along the back and side of the shoulder. Microfracture is another technique that can be used in conjunction with the CAM procedure to regenerate cartilage helping to alleviate the pain and stiffness for arthritic shoulders.
Recently some newer, bone-preserving types of shoulder replacement have been used in young patients who have more end-stage types of shoulder arthritis as a way to preserve more native tissue and to save bone stock for future surgeries that might be needed. There are many different factors to consider for shoulder injuries that cause arthritis. Furthermore, as one might expect there can be several treatment options and risks with benefits with each type that should be discussed with your surgeon after an evaluation.
For young athletes and their parents, it is crucial to understand that degenerative conditions associated with injury and years of training may become a large burden later in life, once their sporting careers are over. Arthritis typically gets worse with age. It is crucial that all athletes understand how to protect themselves during sports and follow the recommended safety guidelines when it comes to stretching, therapy, wearing protective devices and guards.
But most importantly, says Dr. Millett, “Knowing when to take a break and when to rest seems to be one of the most overlooked points of all. There is no reason to paly hurt. The body has an amazing ability to heal itself. When injured, rest and appropriate orthopaedic care can help save the joints of many of our young athletes for years and years to come.”